Project 1 - Substance Abuse Treatment Pathways for Employee Groups A key issue in facilitating both initial and continued access to substance abuse treatment is to understand the pathways by which individuals may enter and participate in treatment. In the private sector, employees and their dependents often have multiple options in terms of pathways to specialty treatment, including managed behavioral health care (MBHC) carve-out plans and employee assistance programs (EAPs) - both of which may be provided by the same managed behavioral health organizations (MBHOs). This study offers the opportunity to investigate the interrelationships in utilization patterns and costs among MBHC, EAP, and other resources for substance abuse problems. The study will use claims eligibility, authorization, and initial assessment data from Managed Health Network (MHN), a large national MBHO. In addition, the investigators will conduct a survey of MHN enrollees, including both users and non-users of MHNsubstance abuse treatment services. The study will investigate whether there are differences in substance abuse utilization, costs and enrollee perceptions of care between integrated (EAP/MBHC) and stand-alone component products. Specific questions include: whether there are differences in choice of pathway by enrollee or product characteristics; how utilization patterns and costs vary depending on pathway or product structure; which appears to facilitate earlier intervention; what barriers are perceived by enrollees in regard to potential help resources; how experiences of care differ by pathway; how enrollee awareness and perception of services affects willingness to use services; and whether MBHC and EAP services appear to function as substitutes or complements. The results of this study will be of interest to employers, insurers and policymakers, as they shape policies affecting access to care.